Medical scandal results in Nobel Prize judges being fired

Two high profile members of the Nobel Assembly were asked to resign as part of the fallout from the scientific scandal centered on Dr. Paolo Macchiarini — a scandal that left two people dead and tarnished the reputation of the Nobel Prize for Physiology and Medicine.

Macchiarini was the first surgeon to perform a transplant of a biosynthetic trachea, but two of three patients to receive such a transplant have died. And Swedish prosecutors are investigating Macchiarini on potential charges of involuntary manslaughter — charges which the surgeon has previously disputed, according to the Associated Press.

On Tuesday, the Nobel Assembly, which is in charge of choosing the recipient of the institution’s prize for physiology or medicine, asked Harriet Wallberg-Henriksson and Anders Hamsten, two of its 50 judges, to resign. Both are former vice-chancellors of the Karolinska Institute, the prestigious Swedish medical university associated with the Karolinska University Hospital which employed Macchiarini.

In addition, Swedish Minister of Higher Education and Research Helene Hellmark Knutsson said publicly that she has dismissed Harriet Wallberg-Henriksson from her position as Sweden’s chancellor of all public universities.

Knutsson has also called for all Karolinska Institute board members who were active while Macchiarini was employed by the institution to step down. Any who choose not to resign will be replaced, Reuters reported.

The Karolinska Institute fired Macchiarini in March.

This week’s firings came after a pair of reports criticizing both Macchiarini and the institute were made public.

At the center of the scandal is Swedish thoracic surgeon Macchiarini.

“Scandal is the right word,” Knutsson told the BBC. “People have been harmed because of the actions of the Karolinska Institute and also the Karolinska University Hospital.”

When Macchiarini first came to the institute, he was praised by the media as a super-scientist, a sort of wunderkind.

Macchiarini captured headlines in 2011, a year after he had been recruited by the institute, for his work in regenerative medicine. That year he implanted a “bioartificial” trachea, one made from plastic and the patient’s own stem cells, into a man named Andemariam Beyene.

It seemed groundbreaking, at the time.

“I almost refused,” Beyene told the New York Times. It had only been done in pigs. But [Macchiarini] convinced me in a very scientific way.”

Thomson Reuters BioWorld likened his work to “science fiction” and the New York Times called it “a first.”

But in Jan. 2014, as the Iceland Review noted, the trachea Macchiarini had implanted became loose, killing Beyene.

He wasn’t the only patient of Macchiarini to die.

Including Beyene’s, Macchiarini performed three of these transplant surgeries at Karolinska University Hospital.

Two of the three died, and one has been in intensive care since the surgery in 2012, Science reported.

Macchiarini made headlines again in 2015 when an independent review found that he overstated his work - in shocking ways.

The Washington Post’s Sarah Kaplan wrote at the time: “The investigator who examined his studies said that Macchiarini was guilty of scientific misconduct by omitting or fabricating information about his patients’ postoperative status to make the procedure seem more successful than it really was.”

Macchiarini’s reported misdeeds were later found to run even deeper, when a report last week found that only one of the three patients signed a consent form. All were capable of doing so.

Even that one signed form “would not have been approved” since the patient wasn’t afforded the option of discussing the procedure with an independent medical expert, the report said.

The report pointed out that a different synthetic material was used in each transplant, which hinted at a lack of research into which one actually worked and suggested an unreadiness for usage in human beings.

“Too little was known about the material in order for it to be able to begin to be used in patients,” it stated.

Finally, it stated that growth-stimulating drugs were used in at least two of the surgeries without the necessary permit from the Swedish Medical Products Agency.

Another report, this one led by former president of Sweden’s Supreme Administrative Court Sten Heckscher and released Monday, was also highly critical of the renowned institution itself, claiming that Karolinska “has a certain responsibility for the transplantation.”

The English version of the report stated: “There are many instances of KI employees being involved in the discussions preceding and following up surgery. KI has also, in several contexts, cited the transplantations as part of its own activities. For example, they have been quoted as research successes in KI’s evaluations of how research funding has been utilized.”

This report opined that KI never should have hired Macchiarini in the first place, considering the “remarkably negative references” the institution received concerning the surgeon.

“KI received remarkably negative references, including information that Macchiarini had been blocked from a professorship in Italy, that there were doubts surrounding his research and that his CV contained falsehoods,” it stated.

Lastly, the report found the hospital extended Macchiarini’s contract twice - once in 2013 and one in 2015 - with “no real evaluation or assessment of Macchiarini’s work.”

“Instead, the department management asked Macchiarini to describe his work himself,” it stated. The description was translated and used in the proposal to extend his contract that was submitted to the Recruitment Committee.”

Bo Risberg, a professor emeritus of surgery at the University of Gothenburg in Sweden, told Science that asking Hamsten and Wallberg-Henriksson to resign from the Nobel Assembly was the proper decision.

“The Nobel Prize and the Karolinska are intimately related, particularly to observers outside Sweden,” Risberg said, calling the situation “the biggest scandal we have ever had in Swedish medicine.”

Currently, prosecutors are investigating Macchiarini on potential charges of involuntary manslaughter relating to the two patients who died after receiving the transplants.

Macchiarini has not commented on the new reports, but has previously disputed all charges, according to the Associated Press.